Birth weight is an
essential indicator for assessing child health in terms of early exposure to childhood
morbidity and mortality. Described as a newborn with an excessive birth weight,
fetal macrosomia has become one of the major public health concern because of its
increased risks for both mothers and infants 12.The neonate is considered to be
macrosomic when its birth weight is greater than 4000-4500 g or greater than
90% for gestational age 34. Thus, measuring the birth weight soon
after delivery can
be a fundamental tool for the diagnosis of the fetal macrosomia 5.

On one hand, cesarean
delivery, labor augmentation with oxytocin, protracted labor, postpartum
hemorrhage, infection, 3rd- and 4th-degree perineal tears, and thromboembolic
events are well-known risks that macrosomic newborn poses to the mother 67. On the other hand, birth trauma (shoulder
dystocia, brachial plexus injury, skeletal injuries), prenatal asphyxia,
hypoglycemia, fetal death as well as increased risks of developing hypertension,
obesity, and type 2 diabetes later in life, are the risks of macrosomia in
infants 3. Several studies have identified potential
risk factors related to the causation of macrosomia. These include high pre-pregnancy
Body Mass Index (BMI), excessive weight gain during pregnancy, gestational
diabetes and fasting blood glucose, multiparty, male sex, parental height, and
prolonged gestation 38.

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A broad
understanding of the underlying risk factors is essential to inform
well-designed preventive and management efforts. In Malawi, most efforts have
been concentrated on under-nutrition as well as low birthweight in children
under the age five. However, fetal macrosomia has received no attention despite
its detrimental effects on childhood health outcomes. According to the Malawi
Demographic and Health Survey (MDHS), Four percent of births are reported as
very small, 12% as smaller than average, and 83% as average as or larger than
average 9. Thus, we aimed to investigate the
factors associated with fetal macrosomia.

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